Fusion · Hip

Open fusion of the symphysis pubis, including bone graft harvest when performed

Verified May 8, 2026 · 6 sources ↓

Medicare: $803.29
Work RVU: 11.55
Global, days: 90
Region: Hip

Drawn from CMSCgsmedicareAAOSEmedny

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 6 cited references ↓

Explicit identification of the symphysis pubis as the operative site — not just 'anterior pelvis' or 'pelvic ring'
Indication for arthrodesis: diagnosis code(s) supporting instability, diastasis, or chronic osteitis pubis
Description of graft source (autograft iliac crest, allograft, or other), quantity harvested, and preparation
Fixation method described by implant type and placement (e.g., plate and screw construct, number of screws, trajectory)
Patient positioning, approach, and layer-by-layer closure documented in the operative note
If fluoroscopy was used intraoperatively, note it as included — do not bill separately
Postoperative plan including weight-bearing restrictions to support medical necessity documentation

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 52 Reduced services 57 Decision for surgery 58 Staged or related 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27282 describes open arthrodesis of the symphysis pubis — the fibrocartilaginous joint at the anterior pelvis — including procurement of bone graft as part of the same operative session. The procedure is performed for conditions such as symptomatic pubic symphysis diastasis (commonly from pelvic ring disruption), osteitis pubis refractory to conservative care, or instability following trauma or parturition. Internal fixation hardware is typically used to stabilize the fusion construct, and fluoroscopic imaging used intraoperatively is bundled into this code.

This is a 90-day global procedure. All routine postoperative care, including wound checks and hardware monitoring visits through day 90, is included in the global package. Services unrelated to the symphysis fusion billed during the global window require modifier 24 (E/M) or modifier 79 (unrelated procedure). If a staged or planned additional procedure is required within the global period, modifier 58 applies.

Because 27282 sits within the pelvic girdle arthrodesis family alongside 27280 (sacroiliac joint) and 27284 (hip joint arthrodesis), correct selection depends on precise anatomic documentation. Billing 27282 with 27280 or 27284 on the same date is possible when distinct pelvic ring segments are addressed, but each combination must survive NCCI PTP scrutiny — verify the edit pair and modifier indicator before submitting.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (11.55) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (24.05) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	11.55
Practice expense RVU	10.03
Malpractice RVU	2.47
Total RVU	24.05
Medicare national rate	$803.29
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$803.29
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI J8) Ambulatory surgical center (freestanding)	$2,084.06

Common denial reasons

The recurring reasons claims for CPT 27282 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Missing or vague diagnosis: ICD-10 code does not map to a condition justifying symphysis fusion (e.g., unspecified pelvic pain without structural diagnosis)
Operative note identifies only hardware placement without documenting the arthrodesis technique or graft use
Duplicate billing of intraoperative fluoroscopy as a separate radiology code — bundled into 27282
Global period conflict: postoperative E/M visits billed without modifier 24 when unrelated condition is the reason for the visit
Site-of-service mismatch between the place of service on the claim and the facility type billed (HOPD vs. ASC)

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01Is bone graft harvest billed separately when performed with 27282?

No. The code descriptor includes obtaining the graft. Do not add a separate graft harvest code — it is bundled.

02Can 27282 and 27280 (sacroiliac arthrodesis) be billed together on the same date?

Potentially yes, if both the symphysis pubis and sacroiliac joint are fused in the same session for pelvic ring reconstruction. Verify the NCCI PTP edit pair for 27282/27280 and apply modifier 59 or XS only if the edit allows it and the operative note clearly documents both distinct anatomic sites.

03What modifier applies if the surgeon performs an unplanned return to the OR within the 90-day global to address a wound complication from the original fusion?

Use modifier 78 — unplanned return to the OR for a procedure related to the original surgery during the global period. Do not use modifier 79, which is reserved for unrelated procedures.

04Does 27282 cover internal fixation hardware placement?

Yes. Fixation performed as part of the symphysis arthrodesis is included in the procedure's work value. Do not separately bill fixation-specific codes for hardware placed to stabilize the fusion construct.

05What ICD-10 diagnoses most commonly support 27282?

Pubic symphysis diastasis from pelvic fracture or disruption (S32.xxx series), osteitis pubis (M86.x8 or M90.x8 depending on etiology), and pelvic instability following trauma. Chronic pain codes alone without structural diagnosis will draw medical necessity scrutiny.

06If a co-surgeon assists with this procedure, how is that reported?

The primary surgeon bills 27282 without a modifier. A co-surgeon (equal participant) uses modifier 62; an assistant surgeon uses modifier 80; a physician assistant uses modifier AS. Payer policy on co-surgeon billing for this code varies — verify before submitting.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the surgical approach to the symphysis pubis, graft harvest site and technique, fixation implant details (plate type, screw count and trajectory), and intraoperative imaging use directly from dictation. This prevents the two most common audit flags for 27282: operative notes that omit graft documentation (triggering a query about upcoding) and claims with separately billed fluoroscopy that should be bundled.

See how Mira captures CPT 27282 documentation